As life expectancy for persons living with HIV has increased due to antiretroviral therapy, quality of life (QOL) has become an emerging issue for older gay men with HIV, who comprise more than 50% of older adults living with HIV in the United States. The purpose of this study was to determine predictors of QOL in older gay men with HIV. Sixty gay men ages 50-65 participated. Age, social support, and problem-focused coping were significantly and positively correlated with QOL, while medical comorbidities, social stigma, and emotion-focused coping were all significantly and negatively associated with QOL (p < .01). In stepwise linear regression analysis, emotional/informational support remained as a significant positive predictor, and medical comorbidities, HIV stigma, and emotion-focused coping remained as significant negative predictors, accounting for 64% of the variance in QOL. Study findings may help researchers develop interventions aimed at increasing QOL in this population. © 2013 Association of Nurses in AIDS Care.